Generic Name: ziprasidone (zi PRAY si done)
Brand Names: Geodon

What is Geodon?

Geodon (ziprasidone) is an antipsychotic medication. It works by changing the effects of chemicals in the brain.

Geodon is used to treat schizophrenia and the manic symptoms of bipolar disorder (manic depression) in adults and children who are at least 10 years old.

Geodon may also be used for purposes not listed in this medication guide.

Important information

You should not use Geodon if you have a a heart rhythm disorder, a history of Long QT syndrome, uncontrolled heart failure, or if you have recently had a heart attack.

Some medicines can cause unwanted or dangerous effects when used with Geodon, and should not be used at the same time. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

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Stop taking Geodon and call your doctor right away if you have a chest pain, severe dizziness, and a fast or pounding heartbeat. These could be signs of a serious heart rhythm problem.

In rare cases, Geodon may cause a severe skin reaction that can be fatal if it spreads to other parts of the body. Stop using this medicine and call your doctor right away if you have a new or worsening skin rash with fever or swollen glands.

Geodon is not approved for use in psychotic conditions related to dementia. This medicine may increase the risk of death in older adults with dementia-related conditions.

Before taking this medicine

You should not use Geodon if you are allergic to ziprasidone, or if you have:

  • a heart rhythm disorder;

  • a personal or family history of Long QT syndrome;

  • uncontrolled or untreated heart failure; or

  • if you have recently had a heart attack.

Geodon is not approved for use in psychotic conditions related to dementia. Geodon may increase the risk of death in older adults with dementia-related conditions.

Geodon should never be taken together with any of the following drugs, or a life-threatening heart rhythm disorder could occur:

  • anagrelide;

  • methadone;

  • tacrolimus;

  • medicine to prevent nausea or vomiting - dolasetron, droperidol, ondansetron;

  • an antibiotic - azithromycin, clarithromycin, erythromycin, levofloxacin, moxifloxacin, pentamidine;

  • cancer medicine - arsenic trioxide, vandetanib;

  • an antidepressant - citalopram, escitalopram;

  • anti-malaria medication - chloroquine, halofantrine, mefloquine;

  • heart rhythm medicine - amiodarone, disopyramide, dofetilide, dronedarone, flecainide, ibutilide, quinidine, sotalol; or

  • medicine to treat a psychiatric disorder - chlorpromazine, haloperidol, mesoridazine, pimozide, thioridazine.

This list is not complete and there may be other drugs that should not be taken at the same time as Geodon. Tell your doctor about all medicines you use.

To make sure Geodon is safe for you, tell your doctor if you have:

  • any heart problems;

  • a history of heart attack or stroke;

  • a history of bone marrow or blood cell disorder;

  • a history of breast cancer;

  • low blood levels of potassium or magnesium;

  • diabetes (ziprasidone may raise your blood sugar);

  • seizures or epilepsy;

  • a history of suicidal thoughts;

  • Alzheimer's disease;

  • trouble swallowing;

  • liver disease; or

  • kidney disease.

Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Taking antipsychotic medication during the last 3 months of pregnancy may cause problems in the newborn, such as withdrawal symptoms, breathing problems, feeding problems, fussiness, tremors, and limp or stiff muscles. However, you may have withdrawal symptoms or other problems if you stop taking your medicine during pregnancy. If you become pregnant while taking Geodon, do not stop taking it without your doctor's advice.

It is not known whether ziprasidone passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

Older adults may be more sensitive to the effects of this medicine.

Geodon is not approved for use by anyone younger than 18 years old.

How should I take Geodon?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take this medicine with food. Swallow the capsule whole.

While using Geodon, you may need frequent blood tests. Your kidney or liver function may also need to be checked.

If you are diabetic, check your blood sugar levels on a regular basis while you are taking Geodon.

Use Geodon regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

It may take several weeks before your symptoms improve. Do not stop using Geodon suddenly, even if you feel fine. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

Store at room temperature away from moisture, light, and heat.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

Geodon dosing information

Usual Adult Dose for Schizophrenia:

Oral:
Initial dose: 20 mg orally twice a day
Maintenance dose: Adjust as clinically indicated at intervals of not less than 2 days
Maximum dose: 100 mg twice a day

Comments: A dose greater than 80 mg twice a day is generally not recommended.

Intramuscular:
Recommended dose: 10 to 20 mg IM; may repeat 10 mg IM every 2 hours or 20 mg IM every 4 hours up to maximum daily dose
Maximum dose: 40 mg IM per day
Duration of therapy: Use beyond 3 consecutive days has not been studied

Comments:
-Coadministration of IM ziprasidone to patient's already taking oral ziprasidone has not been studied and is not recommended.
-If long-term therapy is indicated, oral capsules should replace IM administration as soon as possible.

Uses:
-Treatment of schizophrenia (oral)
-Acute treatment of agitation in schizophrenia (IM)

Usual Adult Dose for Bipolar Disorder:

Acute Treatment of Manic or Mixed Episodes:
-Initial dose: 40 mg orally twice daily
-Increase dose to 60 mg or 80 mg twice daily on the second day; subsequently adjust dose based on tolerance and efficacy within the dose range of 40 to 80 mg orally twice a day
Maintenance Treatment (as adjunct to lithium or valproate):
-Once stabilized, continue on same dose within the range of 40 to 80 mg orally twice daily.

Comments:
-The mean ziprasidone dose administered in flexible-dose clinical trials was approximately 120 mg per day.
-Monotherapy has not been systematically evaluated for maintenance treatment of bipolar I disorder.

Uses:
-As monotherapy for the acute management of manic or mixed episodes associated with bipolar I disorder
-As adjunct to lithium or valproate for the maintenance treatment of bipolar I disorder.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Geodon?

While you are taking Geodon, you may be more sensitive to temperature extremes such as very hot or cold conditions. Avoid getting too cold, or becoming overheated or dehydrated. Drink plenty of fluids, especially in hot weather and during exercise. It is easier to become dangerously overheated and dehydrated while you are taking Geodon.

Geodon may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Avoid drinking alcohol. It can increase some of the side effects of ziprasidone.

Geodon side effects

Get emergency medical help if you have signs of an allergic reaction to Geodon: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

In rare cases, Geodon may cause a severe skin reaction that can be fatal if it spreads to other parts of the body. Stop using this medicine and call your doctor right away if you have a new or worsening skin rash with fever, swollen glands, flu symptoms, easy bruising or bleeding, severe tingling or numbness, muscle weakness, upper stomach pain, jaundice (yellowing of the skin or eyes), chest pain, new or worsening cough, or trouble breathing.

Also call your doctor at once if you have:

  • a light-headed feeling, like you might pass out;

  • chest pain, fast or pounding heartbeats;

  • uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement);

  • low white blood cell counts - sudden weakness or ill feeling, fever, chills, sore throat, mouth sores, red or swollen gums, pain when swallowing;

  • high blood sugar - increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, weight loss; or

  • severe nervous system reaction - very stiff (rigid) muscles, high fever, sweating, confusion, agitation.

Common Geodon side effects may include:

  • dizziness, drowsiness, unusual tiredness;

  • nausea, upset stomach;

  • diarrhea, constipation;

  • feeling restless;

  • tremors;

  • rash; or

  • runny nose, new or worsening cough.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Geodon?

Taking this medicine with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking Geodon with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Many drugs can interact with ziprasidone. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with Geodon. This includes prescription and over-the-counter medicines, vitamins, and herbal products.

Where can I get more information?

  • Your pharmacist can provide more information about Geodon.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Geodon only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2015 Cerner Multum, Inc. Version: 11.01. Revision Date: 2014-12-17, 3:50:21 PM.

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